Serodiscordant condomless anal intercourse common among young men living with HIV

Condomless anal intercourse (CAI), even among serodiscordant (SD-CAI) participants, is common among young, gay, bisexual, and other men who have sex with men (YGBMSM) living with HIV with detectable viral loads, a recent study has shown.

The study included 146 YGBMSM (aged 16–24 years) with detectable HIV viral loads. Sexual risk and behaviours were assessed through interviews, and mental health was evaluated using tools such as the 20-item Centre for Epidemiologic Studies Depression and the Generalized Anxiety Disorder scales. Substance use, social media use, stigma, and beliefs about the transmission of HIV were all also considered as factors.

Participants reported having a median of 1.0 male intercourse partners over the last 3 months. More than half (52.2 percent) noted that they engaged in any type of CAI, of whom 90.0 percent reported receptive CAI.

Notably, 57.1 percent of those who reported any CAI noted that their partner was either HIV negative or had an unknown status.

Relationship status emerged as the strongest predictor for CAI, such that those in a committed partnership were significantly more likely to engage in unprotected intercourse. The risk of CAI was also stronger among those with substance use habits and those who looked for sex online.

The same correlates were found to be important predictors of SD-CAI. This was especially true among those with problematic substance use habits and those who searched for sex partners online daily. Stronger perceptions of a rise in homophobia and a greater degree of internalized homophobia were also important determinants of engaging in SD-CAI.